MEDICARE: NANCY HOLT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0000X	Adolescent Medicine (Internal Medicine) Physician	G65015	CA

General Provider Information

NPI Number	:	1053434506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY HOLT MD

Provider Business Mailing Address
First Line	:	6289 DEL VALLE DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5305
Country	:	US
Telephone Number	:	310-210-9481
Fax Number	:	323-334-1358

Provider Business Practice Location Address
First Line	:	6289 DEL VALLE DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5305
Country	:	US
Telephone Number	:	310-210-9481
Fax Number	:	323-334-1358

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	09/15/2025

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Directions to “ NANCY HOLT MD” Practice Location

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